| Jordan River Support Services | |
|
2616 Langhorne Rd Ste 1 Lynchburg VA 24501-1600 | |
| (434) 250-5943 | |
| (434) 439-2933 |
| Full Name | Jordan River Support Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2616 Langhorne Rd Ste 1, Lynchburg, Virginia |
| Authorized Official Name and Position | Christopher Deshay Carter (CEO) |
| Authorized Official Contact | 4342505943 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan River Support Services 2616 Langhorne Rd Ste 1 Lynchburg VA 24501-1600 Ph: (434) 250-5943 | Jordan River Support Services 2616 Langhorne Rd Ste 1 Lynchburg VA 24501-1600 Ph: (434) 250-5943 |
| NPI Number | 1194211599 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 07/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194211599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2864-03-001 (Virginia) | Primary |
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